艾司氯胺酮在剖宫产术后镇痛中的应用效果及对产妇抑郁的影响

Application effect of Esketamine in postoperative analgesia after cesarean section and its influence on maternal depression

目的探讨艾司氯胺酮在剖宫产术后镇痛中的应用效果及对产妇抑郁的影响。方法选择廉江市人民医院2021年8月至2023年5月行剖宫产手术的80例产妇,采用抽签法分为两组,每组各40例。对照组使用舒芬太尼、阿扎司琼镇痛,观察组在对照组基础上加入艾司氯胺酮,比较两组疼痛、抑郁评分及术后恢复指标、不良反应总发生率。结果观察组术后2、6、12、24 h静息、运动疼痛评分低于对照组(P<0.05),两组术后6、12 h静息、运动疼痛评分较2 h升高(P<0.05),两组术后24 h运动疼痛评分较2 h降低(P<0.05);观察组术后7 d爱丁堡产后抑郁量表评分低于对照组(P<0.05),观察组术后7 d爱丁堡产后抑郁量表评分较术后1 d降低(P<0.05);观察组术后初次排气、初次床边活动时间短于对照组(P<0.05);两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论艾司氯胺酮在剖宫产术后镇痛中的应用效果较好,能够降低术后疼痛程度,改善产妇抑郁情况,促进术后康复。

Objective To investigate the application effect of Esketamine in postoperative analgesia after cesarean section and its influence on maternal depression.Methods A total of 80 pregnant women who underwent cesarean section in Lianjiang People’s Hospital from August 2021 to May 2023 were selected and divided into two groups by lottery method,with 40 cases in each group.The control group was given Sufentanil and Azasetron for analgesia,and the observation group was added Esketamine on the basis of the control group.The pain and depression scores,postoperative recovery indicators,and the total incidence of adverse reactions were compared between the two groups.Results The resting and movement pain scores of the observation group at 2,6,12 and 24 h after operation were lower than those of the control group(P<0.05).The resting and movement pain scores of the two groups at 6,12 h after operation were higher than those at 2 h(P<0.05),and the movement pain scores of the two groups at 24 h after operation were lower than those at 2 h(P<0.05).The score of Edinburgh postnatal depression scale 7 days after operation in the observation group was lower than that in the control group(P<0.05),and the score of Edinburgh postnatal depression scale 7 days after operation in the observation group was lower than that 1 day after operation(P<0.05).The time of first exhaust and first bedside activity in the observation group was shorter than that in the control group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Esketamine has a good application effect in postoperative analgesia after cesarean section,which can reduce the degree of postoperative pain,improve maternal depression and promote postoperative rehabilitation.